For readers here, and those who saw the Washington Post article, who have followed Linda and her family’s struggle with E. coli O157:H7, the report that I received late yesterday from her brother-in-law is heartbreaking.  It seemed only a few days ago that there was talk about her leaving the hospital (where she has been since May 2009) and starting rehabilitation.  There was hope that both her ventilator tube and feeding tube were being removed.  There was a dream that she might one day go home.  Now this:

2-4-2010

I was on the phone with Richard this morning. Linda has developed a condition called “ascites”. Ascites is when the liver weeps out fluid from itself and the fluid builds up within the abdominal cavity. The fluid buildup can get to the point where the person appears similar to a woman who is pregnant. Linda had around 7 liters of fluid in her belly. The doctors “tapped” out the fluid and sent it for analysis.

Why Linda has this fluid buildup is not certain but, very likely, represents progression of her liver problems to cirrhosis. Other possibilities not related to the liver are possible but cirrhosis leads with the highest possibility. Due to this buildup, they decided not to surgically close the tracheotomy (the breathing opening in her throat). Fluid buildup in the belly interferes with breathing mechanics because the fluid interferes with the diaphragm, the anatomic structure that allows us to breathe in and out. Also, this fluid oftentimes leaks into the cavity surrounding the lungs, which can interfere with her ability to obtain oxygen within her lungs. Rather than risk taking out the tracheostomy device and closing the tracheotomy opening, only to have to potentially put down another breathing tube due to respiratory failure, they have elected to keep the opening for as long as this threat remains.

This is a setback, possibly reflecting onset of end stage liver disease. Please keep Linda and Richard in your thoughts and prayers. It has been a roller coaster ride for sure.

A roller coaster ride for sure.